Provider Demographics
NPI:1558240960
Name:STL INTERVENTIONAL ONCOLOGY AND INTERVENTIONAL RADIOLOGY CLINICS, LLC
Entity type:Organization
Organization Name:STL INTERVENTIONAL ONCOLOGY AND INTERVENTIONAL RADIOLOGY CLINICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOOSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-894-3800
Mailing Address - Street 1:641 N NEW BALLAS RD
Mailing Address - Street 2:
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6713
Mailing Address - Country:US
Mailing Address - Phone:314-888-4647
Mailing Address - Fax:
Practice Address - Street 1:641 N NEW BALLAS RD
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-6713
Practice Address - Country:US
Practice Address - Phone:314-785-4647
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-29
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty